Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 1440 | OH |
NPI | 1568546414 |
---|---|
Provider Name | Dr. John David Chiofalo |
First Address | Orrville, OH 44667-1538 |
Second Address | Orrville, OH 44667-1538 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0730374 | (05) | OH |
U17044 | (02) | OH |